Sweden: 2013 Field Report

Published on September 5, 2013
To help solve Sweden’s looming healthcare crisis, emergency medicine will need to project a stronger public image.

Only months after the news that EM would be recognized as a specialty in Sweden, Lund’s ED – one of the best training programs in the country – began to fall apart.

Emergency medicine has evolved quite a bit over the last decade in Sweden and when you take the long view, things are looking promising. But recent activity in the medical community has cast a pall over these developments as budget cuts and politics loom large. Emergency medicine cutbacks in Uppsala and Lund are worrisome reminders that emergency medicine is still not an established specialty in the Swedish medical system.

Although financial constraints are often put forward as the reason for closing down programs, this does not portray the whole truth. There is still a fair amount of hesitation and suspicion towards a new specialty like EM within the medical community. Although EM has now been around for over 10 years there is still no site in Sweden where an emergency department is run 24/7 by emergency physicians. Most EDs have mixed coverage combining emergency medicine residents with on-call physicians from other departments. Thus the true quality and effectiveness of emergency medicine is not witnessed by the Swedish medical community. On top of that most EM residents are not getting close supervison and training the way more matured countries can offer. This has a negative impact on EM’s image with the wider medical community.

This struggle for our specialty comes at a time when there is a nationwide debate about healthcare policies. Dagens Nyheter, the biggest nationwide liberal newspaper, published a series of articles where the problems of our tax-funded health system were addressed. Poor quality, low productivity and foremost lack of will to design the health care system focusing on patient needs became evident.

In this light EM has a chance to thrive. The inherent nature of emergency medicine – where trained physicians care for a wide range of patients simultaneously – should be an appealing solution for those who wish to combine quality and costeffectiveness. However, in order for this to be seen as a viable option, EM awareness needs to grow; it is basically non existent among politicians and the public. In the near future EM needs to evolve fully in a few hospitals in order to set a positive example. Debate over quality and cost in healthcare will continue, but if we look to the global medical community, emergency medicine can rise to the challenge with time-tested solutions to some of Sweden’s most pressing healthcare problems.

This article originally appeared in issue 11 of Emergency Physicians International

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